ABSTRACT
We evaluated the customers, operations, products and advertising of these businesses to explore the unique policy challenges created by the suppliers of waterpipes. We completed a cross-sectional survey consisting of structured site observations and in-person interviews of businesses in New York City, Abu Dhabi and Dubai identified using Google, Yelp, Timeout Dubai and Timeout Abu Dhabi and neighbourhood visits in 2014. Regular customers made up 59% of customers. Franchises or chains were 28% of businesses. Waterpipes made up 39% of sales with 87% of businesses offering food within their menu. Flavoured tobacco made up 94% of sales. Discounts were offered by 47% of businesses and 94% of businesses used advertising, often through social media. The market consists of largely independent businesses, with a large regular customer base, frequently offering diversified services beyond waterpipes. These businesses advertise using both traditional and social media. The economics of waterpipe businesses is very different from the economics of cigarettes, and unique regulatory strategies are needed to control this epidemic